A rhizotomy is a surgical procedure in which several of the spinal nerve roots are severed to address malfunctions in these roots which are causing medical problems. This procedure may also be known as a selective posterior rhizotomy or a selective dorsal rhizotomy. It is performed by a neurosurgeon in a hospital, and a short hospital stay is usually required after the surgery to give the patient an opportunity to recover in the hospital environment before being released to go home.
There are a number of reasons to perform a rhizotomy. One of the most common reasons is spasticity such as that caused by spastic cerebral palsy. Spasticity occurs when muscles contract involuntarily. It can cause contractures of the joints, pain, difficulty moving, and other problems. When a rhizotomy is performed to sever the nerve roots, it resolves the spasticity and gives the patient greater control over her or his movements.
Another reason is pain. If other pain management techniques do not work, a doctor may address the pain at its source, the malfunctioning nerves which are sending the wrong signals and telling the brain that something painful is occurring. This procedure can also be used to treat some types of hypertension.
In the rhizotomy procedure, the patient is anesthetized and positioned face down on the table. A neurosurgeon opens a small incision in the area of interest to expose the nerve roots. The nerve roots are separated and electrically stimulated to find the nerves which are not functioning properly. Once the errant nerves have been identified, the surgeon can sever them so that they do not send signals any more. In radiofrequency rhizotomy, the nerve roots are burned to prevent them from carrying signals.
After the rhizotomy, the patient may experience weakness. In the case of a procedure conducted to treat spasticity, weakness is common, and the patient needs physical therapy to develop strength and tone in the muscles. Other side effects of rhizotomy include transient tingling and odd sensations in the extremities, which usually resolve after six to eight weeks.
There are some risks to this procedure. Anesthesia itself can be risky for patients, and patients are also at risk of unintended nerve damage, paralysis, and permanent weakness. Loss of bladder or bowel control and an increased risk of hip dislocations are also potential risks of rhizotomy. When deciding on whether or not the procedure is appropriate, a patient should talk to a surgeon to get fully informed about the risks, and it is advisable to ask the surgeon about his or her experience and success rate with patients.